Evaluating later or expanded premises hours for alcohol in the night-time economy (ELEPHANT): A mixed methods, natural experiment evaluation

There is strong international review evidence to suggest that even modest increases in late night opening hours for alcohol premises are linked to significant increases in intoxication, assaults and injuries, and create an increased burden on services, especially ambulance, A&E and police services [1-5]. Current evidence has been insufficient to prevent continued liberalisation of trading hours, due to limitations in licensing legislation, and the fact that UK evidence is often valued above international studies [6, 7]. For example, Home Office data show that between 2008 and 2017 there has been a 16% increase in premises with a 24-hour licence in England.

Since late 2018 in Aberdeen City, a total of more that 30 pubs and bars that were previously restricted to a 1am closing time have been granted later opening hours up to 3am. In Glasgow from May 2019, 10 nightclubs were licensed to open for an extra hour until 4am, 7 days a week as a pilot. There is strong evidence from other countries of significant increases in harm (in the order of 20-34%) from even modest changes in opening hours like these. In both cases, the changes were opposed by local public health representatives but they report that their objectives were hampered by the lack of UK evidence.

This change in licensed trading hours in just two cities creates potential for a rare natural experiment that local and national stakeholders argue should be evaluated. They have impressed upon us that there is an urgent need for comprehensive UK-related evidence on the impact of these changes, to inform local policy on standard licensing hours and extensions of hours for individual premises.

We have secured support for the study from public health stakeholders, licensing authorities and licensed premises in Aberdeen, Glasgow, and a control city, Edinburgh; as well as from the licensing lead at Public Health England, the Institute of Alcohol Studies, Alcohol Focus Scotland and Scottish Government alcohol policy team (TBC see letters of support). Scottish Ambulance Service and Police Scotland have agreed to facilitate access to data.

We therefore propose a mixed methods study to evaluate the impact of expanded late night trading on ambulance-call-outs and crimes, the rationale for and implementation of the changes, how services, businesses and patrons have responded, and the economic and longer-term implications.